Paediatrician urges adults to help protect babies
As whooping cough epidemic spreads in NZ, a leading Auckland Paediatrician urges adults to help protect babies
16 May 2012: As numbers of whooping cough (pertussis) cases continue to escalate around the country, a leading Auckland Paediatrician, Dr Cameron Grant, urges people to do more to help protect vulnerable babies.
New Zealand is currently facing a whooping cough epidemic.1 The reported incidence doubled from 2010 to 2011, with over 1,700 cases, 115 hospitalisations and one death. This year there have already been 46 hospitalisations in the Auckland region alone.1 Evidence suggests that the country is experiencing a three to five year peak and even more hospitalisations – particularly among the very young 1, 2
Associate Professor of Paediatrics at the University of Auckland, Dr Grant says, “Babies up until 5 months, and particularly before the age of 2 months are most at risk of whooping cough. During whooping cough ‘peak years’ we can see more than a hundred cases at Starship. It’s a very serious disease for babies and unfortunately only limited options are available to treat it.”
Dr Grant is also a consultant Paediatrician at Starship. He says, “Of the infants admitted to Starship with whooping cough, one in ten will end up in Intensive Care and, of these, one in six will die or be left with brain or lung damage. So it’s important for parents to consider options to protect babies they come in contact with.”
The NZ National Immunisation Schedule starts when the baby is 6 weeks old and includes immunisation against whooping cough. Until then they are very vulnerable to severe disease if they become infected with pertussis, the whooping cough bug. As part of the National Immunisation Schedule children are given whooping cough vaccinations at 6 weeks, 3 months and 5 months and then again at 4 and 11 years. 3-5
Dr Grant says, “Until babies are fully immunised, adults pose the most risk to them. About 70 percent of babies with whooping cough catch this infection from parents or other close family members.”
In addition to being potentially lethal, whooping cough is highly contagious. Dr Grant says that each infected person will pass the disease on to 12 to 15 others. “It’s so infectious that people can’t prevent the spread of whooping cough by good hygiene alone. Unlike most other respiratory illnesses, ensuring you wash your hands thoroughly, and practicing good cleanliness will not prevent a person from contracting the illness. Adult immunisation is something that parents and people who visit newborn babies should also think about.”
“New Zealanders need to start thinking about vaccinating for whooping cough in the same way we think about tetanus. Protection from the tetanus vaccine wears off over time and boosters are required throughout our lifetime. Protection provided by the whooping cough vaccine also wears off over time and most adults will not have received a booster since childhood.
“The symptoms of whooping cough in adults can be difficult to recognise. Initially most people just think they have a cough that is hard to shake. So adults quite often don’t even know they have it and risk passing it on to vulnerable children.”
Dr Grant says immunisation needs to be thought of as a whole-life issue, not just a childhood issue.
“The best way for parents, grandparents and others to protect babies is by getting a whooping cough booster vaccine before spending time with the new addition to the family.”
Although it’s not funded, the Ministry of Health recommends adults who live with, or spend much time with newborns should consider getting immunised with the whooping cough booster. In addition to family and friends, a booster vaccination is also recommended for early childhood educators. 5-6
Asked how to tell if someone has whooping cough, Dr Grant said it can be difficult to diagnose at first.
“For little babies, whooping cough can rapidly develop into a very serious illness. An infant may have no symptoms, and then within a few days of developing a cough become so unwell that they require intensive care. This can all take place in less than a week.
“Whooping cough doesn’t always sound like a ‘whoop’. Whooping cough can cause little babies to stop breathing which is also called “apnoea”. Whooping cough does tend to be worse at night time. Often the cough is so bad that it causes vomiting.
Whooping cough in adults can be even more difficult to diagnose, since symptoms can be atypical. “For other coughing illnesses, the patient coughs a few times and then there is a break in the coughing. Those suffering from whooping cough will cough many times in a row and may have severe breathing problems during each episode.”
For more information on whooping cough and immunisation talk to your GP or Practice Nurse. Alternatively you can visit the Immunisation Advisory Centre website at www.immune.org.nz.
About Dr Cameron Grant
Dr. Cameron Grant is an Associate Professor in the Department of Paediatrics: Child and Youth Health at The University of Auckland and a paediatrician at Starship Children’s Health. He is the Associate Director of Growing Up in New Zealand and of the Centre for Longitudinal Research – He Aka ki Mua, at The University of Auckland. He graduated MBChB from the University of Otago and PhD from the University of Auckland. His postgraduate paediatric training was as a resident at Duke University Medical Center and then a fellow at the Johns Hopkins University.
Dr. Grant returned to the Johns Hopkins University in 2008 as a Fulbright Senior Scholar. In 2008 he became an overseas fellow of the National Institute of Health Research National School of Primary Care (UK).
His teaching skills have been recognised with faculty and university teaching awards including a University of Auckland Teaching Excellence Award for sustained excellence in teaching.
His research focuses on health problems that are common,
affect New Zealand children disproportionately, and are
preventable by immunisation or improved nutrition. He has
published more than 80 refereed research papers, reviews and